Dr Shehata advice

[Wolfemum]

Hello, I am currently experiencing my 3rd consecutive miscarriage and my 2nd MMC. I have been told I will now be referred to the RMC unit but due to my age (42) i think I need to go privately and I was wondering what your opinions are on Dr Shehata? I've heard he has a brilliant reputation but is quite focused on NK cells and less on other things. Can anyone share their thoughts, opinions experiences?
My first pregnancy was healthy and resulted in my 6 year old boy but the last 2 MMC we saw a heartbeat at 6 weeks but then no growth or heartbeat at 7/8 weeks.
Many thanks for reading

@star2022 be kind to yourself. Sometimes I've had to have a chat with dh to explain that the hormones are making me crazy at times and he needs to just put up with it. He just needs reminding sometimes as it's just not on his radar in the same way. Other peoples babies can be so painful, especially when you have to put on a brave face.

I haven't had any extra time off other than appointments, but I could have done with some! I think I might have once taken a day off after transfer too, but I'm not sure. For three of my miscarriages I only had half a day off total, including staying in a first aid course when I started bleeding (I did suspect it was coming) but for my fourth it was medically complicated and it was more emotional so I did get signed off for a couple of weeks. If there's one thing I've learnt (but don't always listen to myself about) is that you really do need to put yourself first. It's just a job. I had an ivf transfer round that happened to fall in a school holiday and it was sooo much less stressful than the others.

@star2022 @seven201 yes I think you’re right. I live in the midlands but luckily work in London so Harley street is great.. but of course they don’t do the intralipids there ;)

isn’t it crazy how we just keep carrying on. In all three of my miscarriages I took 1 day off. The first nothing it was a weekend and the other 2 were only the day In hospital for the D&C both missed and middle one was incomplete.

I find my strongest emotion is being so short tempered.. like I have already had 20 thousand conversations in my head before I’ve actually spoken so I have no time for other issues or people lol. I bet I am a joy to be married to at the moment and that’s before I start trying again haha.

it helps so much having you ladies on here though. It’s doing the world of good for my sanity xx

@seven201 did you get your results back? Hoping it’s all positive x

Been trying to call CRP for prescription nobody is getting back to me! 😩

Annoyingly the first sample didn't have enough DNA in so they tested the second vial and that also didn't have enough DNA. Got those results yesterday and today. Went back for another blood draw this afternoon. Very annoying! I think it will be end of next week now. Thanks for asking.

@seven201 what a nightmare for you. Hoping you’re keeping busy and distracted.

@MeganBistram your previous post was spot on. We must all be made of seriously strong stuff! How are you feeling at the mo? Have you started the prednisolone and other drugs yet? How are you feeling after the Humira?

xx

@KatyTTC thank you. Where are you at with treatment now?

Just done the second Humira jab this eve and I’ve got my bloods on the 17th May. then got results 2 weeks after that and hoping we can move to phase 2 and start trying again.
Although I feel really apprehensive about that too…! It’s been quite nice in a weird way to have a couple of months off from constantly thinking about whether I’m ovulating or being in the TWW etc!

How are you feeling? X

@KatyTTC thats exactly how I felt.. now here I am back in the trying game. I start the prednisone today so I will let you know.

the humira is fine I don’t. Seem to have any issues with that one. By the way completely up to you but I went 4 days after my test to get the results.. too impatient to wait two weeks haha

@seven201 how annoying. Just what you don’t need extra worry. Hopefully they did it correctly this time and you get the results asap :) xx

@KatyTTC oh that's good that you're not far off phase 2 starting. It can be quite daunting. I'm glad you've enjoyed the break from ttc.

I'm fine. Just frustrated at having to wait again. I'm only 13 weeks pregnant but have already been offered a seat and a colleague asked another colleague if I was pregnant . Most of it is chocolate, but I do have a bump that I'm struggling to hide!

@MeganBistram woohoo to getting properly going with this cycle!

@seven201 this is so tricky but at least it’s not that warm so you can hide in loose fitting shirts and strategically placed scarves!
Really hoping you get your results soon.

@MeganBistram keeping everything crossed that this is your cycle.
how are you feeling about trying again?

Hi All,
I am so pleased to have found this thread. Thank you to all the lovely ladies in sharing their experience and explaining the protocols ❤. It has really helped me what to expect before my appointments with Dr. Shehata. Just thought to also jump in and share my experience hoping this would help anyone reading this.

So, I have had 3 early miscarriages (all within week 6). After my second miscarriage, I went with "London Gynaecology" clinic in London and completed all the recurrent miscarriage tests. Result came all normal but then ended up having my 3rd miscarriage. After that point, I was told there is nothing else they can do to help which was very frustrating. I could not stop as I knew my miscarriages would not happen for no reason. It cannot be normal as I kept being told.
After a lot of research, I came across Dr. Shehata on forums and reading all the stories on unanswered miscarriages and how he has helped many women, I thought he may find the cause of my miscarriages also.
The first consultation was available after a month. During the initial consultation recently, he went through the details of my miscarriages, and he then took around 12 blood tests including vitamin D, AMH, full immune profile, and other tests to do with NK which looks at reaction of NK cells during pre-conception, implantation, and pregnancy. He also carried out Sperm fragmentation for my husband. All the tests with the initial consultation costed around £2950 (I did feel like an ATM machine to them).

The results took around 2 weeks. During my second consultation, he went through my results which was honestly very overwhelming.

So, most results showed normal except:

• HIGH NATURAL KILLER CELL COUNT CD16/56: HIGH AT 293.8 (anything >200 is high)
• TOTAL NK %: 11.5% HIGH (anything >12% is high)
• VERY HIGH ACTIVATION MARKER OF NATURAL KILLER CELLS CD69: VERY HIGH AT 2.68 (anything >1.8 very high).

These are at my pre-pregnancy NK cells which all came high (level of my NK during pre-conception- IF I UNDERSTOOD "THE STAGE" CORRECTLY). The level of NK cells in implantation (TH1/TH2) and during pregnancy were all within range.
I have been prescribed the "complex treatment programme" which includes:

• carry on taking preconception multivitamins (omega 3, vitamin d3 2000 units, 75mg aspirin.
• Get intralipid before ovulation on cycle we want to start trying.
• On ovulation day, take progesterone x2, prednisolone 25mg (both daily for 10 days until tested positive for pregnancy. If negative, I would stop until next try.

If positive, they would give me intralipid once a month and I would have to carry on taking aspirin, prednisolone, and progesterone all until week 16 pregnancy. Post week 16, I would not need any treatment. I thought my NK is high pre-conception. If so I am not sure why I need treatment until week 16 (I don't think I understood the purpose of stages well- hopefully DR. Shehata will clarify when I see him next).

My last miscarriage was in jan this year. I have been in a very dark space mentally. The last 2 years has not been easy. But reading everyone’s story on this forum has really helped me to keep going. I have been working really hard on myself to prepare what is about to come once we start trying soon. Praying we all see a positive outcome to this journey🙏

Hi everyone how are you all?

Welcome @Hope646 that's so lovely of you to take the time out to describe the process for any newbies, you explained it all really well. I hope you finally feel like you have some answers. When do you start your treatment? To answer your question regarding needing meds until week 16 - its to prevent any further miscarriages even beyond 6 weeks so you do need to be on the pred for quite a while, and the last few weeks you have to taper off them gradually so it ends up being about the 16th week before you come off them as far as I'm aware.

@MeganBistram What point in your cycle are you? Are you in your two week wait?

@KatyTTC Hope you got on ok with the Humira! I bet you can't wait to get started. I was the same, (not on humira) but I had hydroxy which needed to be in my system for 6 weeks before we could start trying and that wait killed me lol.

@seven201 any updates? hope you're okay

I thought I'd update as I had my scan on Wednesday, I had 2 dominant follicles which was good (I'm on superovulation) and my polyp after surgery was nowhere to be seen thankfully! They said it was quite large in the end 1.5cm x 1.5cm so i'm really hoping this was our reason for infertility along with the nk cells issue. I've been swapped from hydroxy to prednisolone this month for the first time so i'm looking forward to seeing how that goes 🤞

@Hope646 welcome. I was on the complex plan to start with. I think you just don't need most of the drugs after a certain amount of weeks have past. Most you just stop, but prednisolone needs to be weaned off (I'm weaning off at the mo and down to 15). I too found it all very overwhelming but learnt to just trust the process.

@star2022 no updates really. I don't think my NIPT will be back until end of next week. That's such great news about your polyp! 2 dominant follicles is also really good. Good luck this cycle!

@star2022 thank you for clarifying. it makes sense now. I definitely feel more relieved to have an answer and more grateful that there is a treatment for it. I was lost when I kept being told by other doctors (both NHS and private) that it is normal and I still carried on having more miscarriages. Understanding NK cells and after seeing my results, it all makes sense as all my miscarriages were happening so early. Problem with NHS and most private doctors is they only start any sort of treatment (even something as small as aspirin) from week 6 of pregnancy. But my miscarriages all took place before week 6. I don't want to regret saying this but I feel very positive trying soon under Dr. Shehata. It's sad how much we go through, I am scared to even think positive now. with every pregnancy, I started imagining all the good things. Planned so much in my head but the opposite happened. Now every time i think positive or think good things will happen, I stop myself thinking the opposite will happen. I am sure like everyone else, it has taken so much. But still staying strong for next try.

how long have you been on treatment under Dr. Shehata? if you don't me asking, have you started trying under his treatment yet?

@seven201 congratulations on your pregnancy and wish you all the luck at every step. How were the side effects for you? It's been 2 months since i have started gym after I learnt the side effects including causing weight gain. Mentally gym has really helped me but maybe another few weeks of it before we start trying. feeling really nervous as I am already an overthinker especially during the 2 weeks wait and fear of losing after feeling bit of pain.

Also, did any of the medication delayed your period when any of you were unable to conceive? One thing I am thankful for is my cycle is always regular so it helps me track my ovulation at the right time. I am nervous if i fail to conceive the first time, and keep taking the medication, it will be tricky. hoping it does not mess up my cycle.

@seven201 thank you so much. Fingers crossed for you for next week then 🤞🏼

@Hope646 I'm so sorry to hear about your miscarriages, I'm glad you're feeling hopeful and positive. It definitely does help when you have some answers!

So, I saw Dr S in January after having 4 failed ivfs and a chemical (and 4 years of infertility). I tested positive for ANA after my 3rd failed so I looked into it and realised there could be something immune related going on causing my implantation failures. After I got my results back from him, I was told I had normal NK cell count, but my activation was high. I was then put on a superovulation complex protocol in March which was my first cycle, however dr edge found a polyp in my lining during my first scan so after that cycle which obviously didn't work, I had to postpone treatment to get the polyp removed. I had my hysteroscopy done in April 2 weeks ago and now I've just started my second cycle with them which will be my first 'proper' one now that the polyp is gone and i'll be on the steroids for the first time too so i'm pretty new to it! When are you seeing him next? Have you started treatment already or about to?

@star2022 I am so sorry to hear about your losses. Hoping the removal of polyp and finding out about your NK condition will only bring positive outcome soon. keeping everything crossed for you 🙏
I haven't started any treatment yet. We will hopefully start trying in my next cycle. so I think I will have to arrange my appointment for intralipid infusion in 2 weeks time before my ovulation. its going to be 5 months since my last miscarriage so its going to be the right time also. i will keep you all posted how it goes.
I have just been taking all my vitamins, coq10, aspirin. Been trying to eat healthy also. Going through miscarriage really makes you overthink every small action, from how you move to what you eat. you analyze everything

@seven201 how annoying that you have had to wait so long especially when it costs so much money. Have you had the basic bloods done with the NHS 12 week scan yet?

@Hope646 welcome to the gang. Sounds like we are all having very similar experiences. I am on my first try again after all the tests and the drugs ( humaria and hodroxy ) in the dreaded two week wait.

a week today I have the take the early test. The good news is that the steroids have had no side effects or any of the meds.. although the progesterone is rank haha..

@star2022 great news you have two dominant follicles.. we might be on this journey at the exact same time. I will keep everything crossed for you xx

sorry everyone for my slow replies.. I am actually on a cruise with the family which is lovely and helping not have too much time to think About the 2 week wait :)

Thank you @Hope646 got my fingers crossed for you, keep us updated on your journey x

@MeganBistram thank you so much and i'm keeping my fingers crossed for you too 🤞🏼 I'm glad to hear you've not had side effects from the steroids, do you not get the insomnia? I'm triggering tonight, and start steroids and progesterone on tuesday but haven't had steroids at 25mg before so feeling a bit anxious about that. Have you had any symptoms in your 2ww? Although i've heard steroids can mask pregnancy symptoms too so it literally is a waiting game. Good luck for your test day xx

That sounds bliss @MeganBistram the perfect way to keep busy!! Enjoy your break ☀️

@Hope646 sorry for the delay. Side effects I think I came off ok from it all. Steroids and being awake in the night for the first couple of weeks was annoying but it doesn't last forever. This is the longest I've been on steroids and I have go fatter and my face and chin have particularly suffered. When I've only been on it for a short time it's not been an issue. I'm now weaning off and only on 10g as of today so I'm hoping that my face and chin recover at least a bit. I've had a lot of past ivf cycles and side effects from those were worse, I particularly didn't do well with lots of estrogen (headaches). Oh actually, I did lose quite a lot of hair from the hydroxychloroquine, but I don't think everyone does. I've been on that for about 9 months now and it's much less now (was bad for about 4/5 months).

Well done on going to the gym. Great thing to do. I've been walking more, but nothing more than that. I'm definitely too scared to do any exercise or have sex since becoming pregnant. I bled with my dd once after sex and I have a subchronic haematoma (blood clot near placenta) so am taking life pretty slowly. I say that just after I helped moved our kingsize mattress up to our loft room up a stupid twisty staircase. I'm having a rest to recover!

I didn't have very regular cycles so I'm not sure if the meds affect them. If so, it wasn't by much at all. The progesterone can sort of delay your period from starting, but it's definitely worth taking.

@MeganBistram yes, had the standard nhs screening results through, they also come out as high risk and they offered me the NIPT on the phone while I was in CRP waiting room for my re-test. Really hope I get the results this week or I might go mad! I hope you're having an amazing time on the cruise - so nice!! What a good 2ww distraction.

I had my re-test NIPT results through and all low risk and a it's a girl! Really thought it was a boy and obviously very relieved the downs results came through fine in the end.

@seven201 wooooo hoooo!! Oh this is such amazing news and how exciting is a beautiful baby girl!! Huge congratulations xx